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題名:照護口腔癌併腫瘤蕈狀傷口病患之護理經驗
書刊名:長庚護理
作者:林怡君陳淑真
作者(外文):Lin, Yi-chunChen, Shu-chen
出版日期:2015
卷期:26:2=90
頁次:頁192-202
主題關鍵詞:口腔癌腫瘤蕈狀傷口羅氏適應理論Oral cancerMalignant fungating woundRoy' adaptation model
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:30
  • 點閱點閱:79
口腔癌常伴隨疼痛及難癒合之蕈狀傷口。本篇為探討一位口腔癌合併腫瘤蕈狀傷口之病患,護理期間於2012年12月10日至2013年1月12日止,筆者運用羅氏適應模式理論為評估架構,利用觀察、筆談、家屬會談、身體評估、直接照護等方式進行資料收集與分析,確立病患護理問題有慢性疼痛、組織完整性受損、身體心像紊亂及無望感等。護理過程中,藉由提供舒適環境減緩病患疼痛情形,教導淨化呼吸法和漸進式肌肉放鬆法於換藥時轉移注意力,使病患達到放鬆功效,並適時評估傷口變化,教導適當擺位以避免組織受壓迫而影響血循,並利用傾聽方式了解病患對傷口導致身體心像改變的感受,增加對自我照顧的參與感,並正向面對傷口,藉此經驗分享,期望能提供護理人員在照護上之參考。
Oral cancer is commonly associated with pain and fungating wounds. Thus, providing patients with approaches to mitigate this condition is necessary. This study investigated a patient with oral cancer and comorbid fungating wounds. The patient received nursing care between December 10, 2012 and January 12, 2013. This study implemented the Roy's adaptation model as an evaluation framework, collecting and analysing data based on various methods (e.g., observations, written communication, interviews with family members, physical evaluations, and direct care) to determine problems of the patient, such as chronic pain, impaired tissue integrity, body image disturbances, and feelings of hopelessness. During the process of nursing care, we furnished a comfortable environment for the patient to alleviate their pain. In this environment, the patient was taught sudarshan kriya practices and progressive muscle relaxation methods, in order to divert his attention and relax him during dressing changes. In addition, we performed timely assessments of variation in the wound, taught the patient appropriate positioning to avoid applying pressure to tissues and hindering blood circulation. By listening to the patient's concerns, we determined the patient's feelings regarding changes in body image resulting from the wounds, willingness for selfcare, and positivity toward wound conditions. Through experience sharing, this study expects to provide nurses with a nursing care reference.
期刊論文
1.許美玉、王英偉(20060800)。惡性蕈狀傷口常見症狀處置與護理策略。慈濟醫學,18(4)增刊,31-36。  延伸查詢new window
2.Grocott, P.(2007)。Care of patients with fungating malignant wounds。Nursing Standard,21(24),57-66。  new window
3.江慧珣、莊于君、周桂如(20011200)。癌症疼痛之處置。腫瘤護理雜誌,1(2),64-73。  延伸查詢new window
4.周繡玲(20040800)。惡性腫瘤蕈狀傷口整體性的評估與照護。安寧療護,9(3),286-298。new window  延伸查詢new window
5.Clark, J.(2002)。Metronidazole gel in managing malodorous fungating wounds。British Journal of Nursing,11(Suppl. 6),54-60。  new window
6.林美瑩、柯薰貴(20080600)。一位口腔癌末期病患之護理經驗。腫瘤護理雜誌,8(1),51-64。  延伸查詢new window
7.洪立嚴、陳蕙茹(20101100)。照護一位頰膜癌病人合併腫瘤蕈狀傷口之護理經驗。源遠護理,4(2),59-66。  延伸查詢new window
8.蘇莉婷、劉倖吟、相青琪(20111200)。照顧一位罹患口腔癌患者之護理經驗。腫瘤護理雜誌,11(2),49-62。  延伸查詢new window
9.Seaman, S.(2006)。Management of malignant fungating wounds in advanced cancer。Seminars in Oncology Nursing,22(3),185-193。  new window
10.高以信、李楊成(20070500)。臨床醫療之癌症疼痛控制。基層醫學,22(5),178-183。  延伸查詢new window
11.羅淑芬、胡文郁(20080200)。論述惡性蕈狀傷口對癌症病人的生理、心理、社會與靈性衝擊。護理雜誌,55(1),75-80。new window  延伸查詢new window
12.唐婉如(20080600)。癌症病人之靈性評估與照護。腫瘤護理雜誌,8(1),13-25。  延伸查詢new window
13.張瓈方、張乃文、王桂芸(20100300)。身體心像紊亂之概念分析。長庚護理,21(1)=69,25-32。new window  延伸查詢new window
14.闕昀珮、張東杰、林秀峰、游靜宜、鄭夙芬、康仲然、陳一豪(20111100)。口腔癌病患社會支持、憂鬱焦慮之探討與社會支持介入之影響。臺灣耳鼻喉頭頸外科雜誌,46(6),329-339。  延伸查詢new window
會議論文
1.Lo, S. F.、Hsu, M. Y.(200607)。Clinic follow-up of patient with malignant fungating wounds in adults in Taiwan。16th biennial congress of the World Council of Enterostomal Therapists。Hong Kong Enterostomal Therapists Association。  new window
圖書
1.廖繼鼎(2010)。臨床腫瘤學。台北市:合記。  延伸查詢new window
其他
1.Naylor, W.(2002)。Part 2: Symptom self-assessment in the management of fungating wounds,http://www.worldwidewounds.com/2002/july/Naylor-Part2AVound-Assessment-Tool.html, 2006/12/10。  new window
2.衛生福利部統計處(2013)。101年死因統計分析,http://www.mohw.gov.tw/cht/DOS/Statistic.aspx?f_list_no=312&fod_list_no=2747, 2013/01/20。  new window
 
 
 
 
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